Best Probiotics for Constipation: Expert Reviews and Recommendations

If you are searching for the best probiotic for constipation, you are not alone. Constipation is a common digestive issue that affects millions of people worldwide. While there are various treatment options available, probiotics have emerged as a popular and effective solution. Here, we’ll explore the role of probiotics in managing constipation and help you find the best probiotic strains to alleviate your symptoms.

What is constipation?

Constipation is a digestive disorder characterized by infrequent bowel movements, typically less than three per week, or difficult passage of stools. Symptoms may include:

• Hard, lumpy stools
• Straining during bowel movements
• Feeling of incomplete evacuation
• Abdominal pain or bloating

It’s important to note that everyone’s bowel habits are different, and what’s considered “normal” can vary from person to person.

What causes constipation?

Several factors can contribute to constipation, including:

• Poor diet (low in fiber and plant-based foods)
• Dehydration
• Certain medications (e.g., iron supplements, opioid painkillers)
• Pregnancy
• Sedentary lifestyle
• Stress
• Gastrointestinal disorders (e.g., pelvic floor dysfunction, hypothyroidism)

How to manage constipation:

Managing constipation often involves a combination of lifestyle changes and therapeutic interventions. Common strategies include:

• Increasing fiber intake through diet or supplements
• Staying hydrated
• Regular physical activity
• Over-the-counter laxatives (e.g., bisacodyl, senna)
• Prescription medications (e.g., lactulose, lubiprostone)

However, many people find these conventional treatments unsatisfactory and seek alternative options, such as probiotics.

The gut microbiome and constipation:

The human gut is home to trillions of bacteria, collectively known as the gut microbiome. A healthy gut microbiome is characterized by a balance between beneficial and harmful bacteria. Dysbiosis, or an imbalance in the gut microbiome, has been linked to various digestive disorders, including constipation (5, 6).

Probiotics, which are live microorganisms that confer health benefits when consumed in adequate amounts, can help restore balance to the gut microbiome and alleviate constipation symptoms.

Probiotics for constipation:

Probiotics, particularly those containing Bifidobacteria and Lactobacillus species, have shown promise in managing constipation. These beneficial bacteria are thought to improve bowel function through several mechanisms (7)

• Production of short-chain fatty acids (SCFAs), which stimulate peristalsis and increase serotonin levels in the colon (8)
• Decreased colonic pH due to increased lactic acid and SCFA production, promoting peristalsis (9)
• Increased bile salt metabolism, which stimulates colonic motility (10)

The best probiotic strains for constipation:

Several probiotic strains have been clinically studied for their effectiveness in managing constipation. The best probiotic supplements for constipation should contain one or more of the following strains:

Bifidobacterium lactis BB-12®
B. lactis BB-12® has been extensively researched and shown to be effective in improving bowel regularity. In a large clinical trial, supplementation with B. lactis BB-12® significantly increased defecation frequency in individuals with constipation (11). This strain has also been successfully trialed in elderly individuals and pregnant women, who are more susceptible to constipation.

Bifidobacterium lactis HN019
Multiple clinical studies have demonstrated the efficacy of B. lactis HN019 in managing constipation. In a gold-standard trial, supplementation with B. lactis HN019 significantly increased stool frequency and reduced whole gut transit time in constipated individuals (12, 13). A meta-analysis also highlighted the medium to large treatment effects of B. lactis HN019 on intestinal transit time (14).

Bifidobacterium animalis subsp. lactis DN-173 010
B. lactis DN-173 010 has shown promise in reducing colonic transit time and improving constipation symptoms. In a double-blind study, consuming milk fermented with B. lactis DN-173 010 reduced colon transit time by 20%, with more pronounced effects in women (15). Another gold-standard trial demonstrated a significant reduction in colonic transit time in individuals with IBS-constipation who consumed yogurt containing B. lactis DN-173 010 (16).

Lactobacillus rhamnosus GG® (LGG®)
While LGG® is a well-known probiotic strain with various health benefits, its efficacy in managing constipation when used alone remains unclear. Some studies have shown positive results when LGG® is combined with other treatments, such as prebiotic fibers, but more research is needed to assess its standalone effectiveness (17, 18).

Natural probiotics for constipation:

In addition to probiotic supplements, there are natural probiotic products available that can help alleviate constipation symptoms. Two notable examples are:

Yourbiology Gut+

Yourbiology Gut+ is a natural probiotic supplement designed to support digestive health and regularity. It contains a blend of clinically-studied probiotic strains, including Bifidobacterium lactis BB-12® and Lactobacillus rhamnosus GG®, along with prebiotic fibers to nourish the beneficial bacteria in the gut.

Biotics 8

Biotics 8 is another natural probiotic supplement that has been formulated to support digestive health and alleviate constipation. It contains a proprietary blend of eight probiotic strains, including Bifidobacterium lactis HN019 and Bifidobacterium animalis subsp. lactis DN-173 010, which have been shown to be effective in managing constipation in clinical studies.

Can prebiotics help constipation?

Prebiotics, which are non-digestible compounds that serve as food for beneficial gut bacteria, may also help alleviate constipation. Prebiotics are thought to have a mild laxative effect without the risk of dependency. Combining the probiotic B. lactis BB-12® with prebiotic fibers is widely recognized as an effective approach to managing constipation and maintaining normal bowel function.

Dietary sources of probiotic bacteria:

In addition to probiotic supplements, certain foods can help boost levels of beneficial bacteria and support digestive health. Probiotic-rich foods include

• Natural live yogurt
• Fermented foods (e.g., sauerkraut, kimchi)
• Kefir
• Kombucha
• Miso
• Tempeh

These foods are particularly rich in Lactobacillus bacteria, which can contribute to a healthy gut microbiome.

Frequently Asked Questions (FAQs):

What type of probiotic is best for constipation?

The best probiotics for constipation are those that contain clinically-studied strains of Bifidobacteria and Lactobacillus, such as Bifidobacterium lactis BB-12®, Bifidobacterium lactis HN019, Bifidobacterium animalis subsp. lactis DN-173 010, and Lactobacillus rhamnosus GG®. Look for supplements that provide at least 1 billion CFU per serving of these specific strains.

What is the best supplement for regular bowel movements?

The best supplement for regular bowel movements is one that combines clinically-studied probiotic strains with prebiotic fibers. A notable example is Optibac Bifido & Fibre, which contains Bifidobacterium lactis BB-12® along with prebiotic fibers to support digestive health and regularity.

What is the best fiber for constipation?

The best fibers for constipation are soluble fibers, such as psyllium husk, inulin, and partially hydrolyzed guar gum (PHGG). These fibers absorb water and form a gel-like substance, which helps to soften stools and promote regular bowel movements. Prebiotics, such as fructo-oligosaccharides (FOS) and galacto-oligosaccharides (GOS), are also beneficial as they nourish the beneficial bacteria in the gut.

When is the best time to take probiotics for constipation?

The best time to take probiotics for constipation is typically in the morning, before or with breakfast. This allows the beneficial bacteria to work throughout the day and support regular bowel movements. However, it’s essential to follow the instructions provided by the manufacturer of your specific probiotic supplement, as some may recommend taking the product at a different time of day.

Summary of probiotics for constipation:

Constipation is a common digestive issue that can significantly impact quality of life. While conventional treatments like laxatives and fiber supplements are often used, many people find them unsatisfactory and seek alternative options. Probiotics, particularly strains of Bifidobacteria and Lactobacillus, have emerged as a promising solution for managing constipation.

The best probiotic strains for constipation, based on clinical research, include B. lactis BB-12®, B. lactis HN019, and B. lactis DN-173 010. These strains have been shown to increase stool frequency, reduce colonic transit time, and improve overall constipation symptoms.

In addition to probiotic supplements, prebiotics and probiotic-rich foods can help support a healthy gut microbiome and promote regular bowel function. If you’re considering probiotics for constipation, it’s essential to choose a high-quality supplement containing clinically-studied strains and to consult with a healthcare professional to determine the best approach for your individual needs.

References:

1. Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011;106(9):1582-1591.
2. Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology. 2016;150(6):1393-1407.e5.
3. Forootan M, Bagheri N, Darvishi M. Chronic constipation: A review of literature. Medicine (Baltimore). 2018;97(20):e10631.
4. Johanson JF, Kralstein J. Chronic constipation: a survey of the patient perspective. Aliment Pharmacol Ther. 2007;25(5):599-608.
5. Zhu L, Liu W, Alkhouri R, et al. Structural changes in the gut microbiome of constipated patients. Physiol Genomics. 2014;46(18):679-686.
6. Ohkusa T, Koido S, Nishikawa Y, Sato N. Gut microbiota and chronic constipation: a review and update. Front Med (Lausanne). 2019;6:19.
7. Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014;100(4):1075-1084.
8. Hurst NR, Kendig DM, Murthy KS, Grider JR. The short chain fatty acids, butyrate and propionate, have differential effects on the motility of the guinea pig colon. Neurogastroenterol Motil. 2014;26(11):1586-1596.
9. Xu C, Yan M, Sun Y, et al. Prevalence of Helicobacter pylori infection and its relation with body mass index in a Chinese population. Helicobacter. 2014;19(6):437-442.
10. Floch MH, Walker WA, Madsen K, et al. Recommendations for probiotic use-2011 update. J Clin Gastroenterol. 2011;45 Suppl:S168-S171.
11. Eskesen D, Jespersen L, Michelsen B, Whorwell PJ, Müller-Lissner S, Morberg CM. Effect of the probiotic strain Bifidobacterium animalis subsp. lactis, BB-12®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: a randomised, double-blind, placebo-controlled, parallel-group trial. Br J Nutr. 2015;114(10):1638-1646.
12. Ibarra A, Latreille-Barbier M, Donazzolo Y, Pelletier X, Ouwehand AC. Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: A double-blind, randomized, placebo-controlled, and dose-ranging trial. Gut Microbes. 2018;9(3):236-251.
13. Waller PA, Gopal PK, Leyer GJ, et al. Dose-response effect of Bifidobacterium lactis HN019 on whole gut transit time and functional gastrointestinal symptoms in adults. Scand J Gastroenterol. 2011;46(9):1057-1064.
14. Miller LE, Ouwehand AC, Ibarra A. Effects of probiotic-containing products on stool frequency and intestinal transit in constipated adults: systematic review and meta-analysis of randomized controlled trials. Ann Gastroenterol. 2017;30(6):629-639.
15. Marteau P, Cuillerier E, Meance S, et al. Bifidobacterium animalis strain DN-173 010 shortens the colonic transit time in healthy women: a double-blind, randomized, controlled study. Aliment Pharmacol Ther. 2002;16(3):587-593.
16. Agrawal A, Houghton LA, Morris J, et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Pharmacol Ther. 2009;29(1):104-114.
17. Waitzberg DL, Logullo LC, Bittencourt AF, et al. Effect of synbiotic in constipated adult women – a randomized, double-blind, placebo-controlled study of clinical response. Clin Nutr. 2013;32(1):27-33.
18. Banaszkiewicz A, Szajewska H. Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo-controlled randomized trial. J Pediatr. 2005;146(3):364-369.